Urinary incontinence, the inability to control urination from the bladder, is a widespread problem in the United States and throughout the world. Urinary incontinence affects people of all ages and can severely impact a patient both physiologically and psychologically.
In approximately 30% of the women suffering from urinary incontinence, incontinence is caused by intrinsic sphincter deficiency (ISD), a condition in which the valves of the urethral sphincter do not properly coapt. In approximately another 30% of incontinent women, incontinence is caused by hypermobility, a condition in which the muscles around the bladder relax, causing the bladder neck and proximal urethra to rotate and descend in response to increases in intraabdominal pressure. Hypermobility may be the result of child delivery or other conditions which weaken, stretch or tear the muscles. In an additional group of women with urinary incontinence, the condition is caused by a combination of ISD and hypermobility.
In males, urinary incontinence may be the consequence of post radical prostatectomy, which can destroy the valves of the urethral sphincter.
In addition to the conditions described above, urinary incontinence has a number of other causes, including birth defects, disease, injury, aging, and urinary tract infection.
Numerous approaches for treating urinary incontinence are available. In one procedure, referred to as bladder neck stabilization (BNS), sutures are placed around the muscles on either side of the urethra and affixed to the rectus fascia or pubic bone and tensioned to treat hypermobility. Other procedures which treat both hypermobility and intrinsic sphincter deficiency (ISD) involve the placement of a sling under the urethra/bladder which compresses the sphincter while simultaneously acting as a stabilizer of the bladderneck (preventing excessive downward mobility). The bone anchors which support the sling sutures may be inserted into rectus fascia or various locations on the pubis bone to provide a non-moveable anchoring method.